Understaffing and Ambulance Service at ERs

While patients with health insurance struggle to get in to the University of Chicago Medical Center, patients without insurance are facing even tougher challenges.

Provident Hospital on Chicago’s South Side stopped ambulance service in February, and is now relying on Cook County’s other hospitals serving indigent patients to take them. The University of Chicago normally does not accept patients without health insurance, but they are legally obligated to at least stabilize those brought to them in emergency situations.

Limiting inpatient care at Provident Hospital cuts the South Side’s access to emergency health care even further, say a group of nurses protesting the decision. The Cook County board looks to John H. Stroger Jr. Hospital, eight miles away on the West Side, as one of these patients’ options.

The decision to stop accepting ambulances is cutting access to care for those without health insurance who rely on nearby Provident, said Gabriel Culbert, one of the nurses upset over the Cook County decision.

“It is the first hatchet blow to dismantling the health care safety net of Chicago,” Culbert said. “Cook County health systems serve the vast majority of indigent patients.”

Tya Robinson-May is a former nurse at nearby Oak Forest Hospital, another of the county’s hospitals previously slated for a downgrade in inpatient care. Although Oak Forest was saved from closure by the Illinois Health Services and Review Board in March, she is involved with a protest against cuts at Provident.

“Provident is vital,” Robinson-May said. “In the area that they live, it’s vital they have ambulance service. The elderly cannot make it to Stroger, they can barely make it to Oak Forest.”

Dennis Kosuth, an Emergency Room nurse at Stroger, said he has seen a dramatic increase in patients, particularly since the downsizing at Provident Hospital.

“Waits in the waiting room are like eight, nine, 10 hours,” Kosuth said.

He cited a memo posted in the Emergency Room in early January that said the staff there had seen around 400 patients a day for three consecutive days — an unprecedented number in such a short time period. That was before ambulances were redirected from Provident.

Kosuth said hospital officials told him Stroger would receive nurses from Provident Hospital, but he has not yet seen any hiring.

Research done in 2002 at the University of Pennsylvania put a number to the burden that nurses face when they are understaffed. It seems that the odds of a patient dying in the hospital increased by 7 percent for every additional patient in the average nurse’s workload.

Dr. Richard David, a pediatrician at Stroger and a member of the Coalition Against Cuts in Health Care, a group of nurses and doctors against the proposals, said he has seen little done about the understaffing.

“It’s not like the hospital has a new policy [to deal with the influx],” said David. “People are overworked and running around like crazy.”

The System Director of Public Affairs at the Cook County Health & Hospitals System, Lucio Guerrero, said that to his knowledge there hadn’t been any surges in patients at the Stroger emergency room. Guerrero said before Provident Hospital stopped receiving ambulances, approximately 75 percent of emergency room patients at Provident walked in.

“If you are in an ambulance and you had to go to Provident, I would hope they would bring you to a closer hospital,” Guerrero said, referencing one of the many hospitals within a five-minute drive of Provident. “[Once they are stabilized,] then they will send them our way.”

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3 responses to “Understaffing and Ambulance Service at ERs”

  1. Monica says:

    Why can’t University of Chicago Hospital be mandated to be Level 1 Trauma if there is a need/shortage in the area in exchange for keeping their not for profit status. Could be calculated into their annual charity care dollar numbers.

    Also, why doesn’t the Illinois Health Facilites & Services Review Board step up to the plate about this?

  2. rashida says:

    Am I blind or should I not say..? The majority of hospitals that are closed to Trauma patient’s are in the poorest of neighborhoods, where the crime is highest, God forbid I or a member of my family are injured on the South side of Chicago while visiting a friend in the hospital or commuting to work! Never mind the fact I actually am a South sider with / without insurance..? Shame! Shame! Shame on The University of Chicago Hospital’s, and their doctors who deny any victim of trauma!!!

  3. Steve B says:

    With all due respect to WTTW, U of C is not the busiest ER in the state. The ER at Cook County definitely treats over 100,000 patients annually in its ER, and that doesn’t include Pediatric and Trauma patients.